Suchergebnisse

University of Maryland, Baltimore. Social Work. Ph.D. 2013 ; Background: There has been an ongoing debate in the trauma field regarding the validity of Post-Traumatic Stress Disorder (PTSD) as a construct among trauma-affected populations displaced from or living in non-Western, low and middle income countries. Some researchers argue that PTSD is a Western construct that is only relevant in Western settings, while others assert that PTSD may be a universal concept. Purpose: To determine if there are a core set of PTSD symptoms that are applicable across three non-Western low and middle income countries (LMIC). Methods: Secondary data analysis was conducted from baseline, screening and validity studies among torture survivors in Northern Iraq, sexual violence survivors in the Democratic Republic of Congo (DRC), and Burmese survivors of mass human rights violations in Thailand. Item response theory (IRT) and confirmatory factor analysis (CFA) was conducted to explore core PTSD symptoms. Results: Confirmatory factor analyses indicated that the best fitting model for the whole sample was a 4-factor "numbing" model (with effortful avoidance, arousal, numbing and intrusion factors). Results from the multidimensional IRT rating scale model indicated four core items across the whole sample. Accounting for multidimensionality with the "numbing" PTSD model, the four items were from the effortful avoidance and arousal domains. Results revealed that seven items demonstrated differential item functioning were from the re-experiencing, numbing, and arousal domains. All items demonstrated statistically significant differential item functioning but small to moderate effect size. Conclusions: Core items found across the three countries are indicative of culturally relevant items that are concrete in nature, as well as relatively easy to measure and operationalize. The small effect size in the potential DIF items suggests that there is little meaningful/clinical difference of the items across country for general screening of PTSD ...

Latino migrant day laborers are a transnational population that often travels back and forth between borders in search of economic opportunities. These Latino day laborers (LDLs) are often at risk for exploitation and worker's rights abuses. Despite LDLs' heightened social vulnerability and risks, this population often does not access formal social or public health services due to their undocumented legal status, lack of health insurance and distrust of governmental social services. In light of LDLs' lack of access to formal services, social networks may enhance and protect their well-being and health through the exchange of emotional and social support, as well as the provision of concrete and practical services. Utilizing Berkman, Glass, Brissette, and Seeman's (2000) conceptual framework on social networks and health, this ethnographic study investigates the role of social networks in facilitating the well-being of LDLs (N=150). Implications for social services for this transnational population are also discussed.

Objectives: The purpose of this study was to explore perceptions of Family-Centered Practice (FCP) among child welfare workers who are expected to use FCP principles in their work with children and families. Method: Nine focus groups were conducted among child welfare workers across seven different regions within one state to assess caseworker's experiences with FCP. Results: Themes related to time, resources and opportunities, work climate, and engagement emerged from the analysis in relation to the implementation of FCP. Conclusions: Implications of the implementation of the FCP framework for social work policy and practice are discussed.

Background: From 1986-9, the Kurdish population of Iraqi Kurdistan was subjected to an intense campaign of military action, and genocide by the central Iraq government. This campaign, referred to as the Anfal, included systematic attacks consisting of aerial bombings, mass deportation, imprisonment, torture, and chemical warfare. It has been estimated that around 200,000 Kurdish people disappeared. Purpose: To gain a better understanding of current priority mental health and psychosocial problems among Kurdish survivors of the Anfal, and to inform the subsequent design of culturally appropriate and relevant assessment instruments and services to address these problems. The study examined 1) the nature and cause of current problems of survivors of torture and/or civilian attacks and their families, 2) what survivors do to address these problems, and 3) what they felt should be done. Methods: We used a grounded theory approach. Free list interviews with a convenience sample (n=42) explored the current problems of Kurdish persons affected by torture. Subsequent key informant interviews (n=21) gathered more detailed information on the priority mental health problem areas identified in the free list interviews. Results: Major mental health problem areas emerging from the free list interviews (and explored in the key informant interviews) included 1) problems directly related to the torture, 2) problems related to the current situation, and 3) problems related to the perception and treatment by others in the community. Problems were similar, but not identical, to Western concepts of depression, anxiety, PTSD and related trauma, and traumatic grief. Conclusion: Iraqi Kurdish torture survivors in Iraq have many mental health and psychosocial problems found among torture survivors elsewhere. The findings suggest that the problems are a result of the trauma experienced as well as current stressors. Development of mental health assessment tools and interventions should therefore address both previous trauma and current stressors.

Abstract
HIV interventions that attend to mental health problems among vulnerable populations in sub-Saharan Africa have become a priority. This is especially so among mobile populations, such as female fish traders in Zambia, who are at increased risk of trauma, subsequent adverse mental health risks including post-traumatic stress and HIV risk or transmission risk behaviours. To date, there have been no known integrated HIV and mental health interventions among mobile populations in Zambia. Furthermore, although the adaptation of evidence-based interventions to address intersecting risks in non-western contexts has been growing, there is a gap in rigorous adaptation research methods that rely upon the target population for collaborative contextual input. This article aims to describe the application of the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff and Testing) method to adapt an evidence-based intervention (Living in the Face of Trauma) to address intersecting HIV, trauma and mental health risks among female fish traders in Zambia. More specifically, we describe the collaborative and iterative process used and highlight the unique role of social workers throughout this process. Results from the ADAPT-ITT method show promise for the adapted intervention, In Solidarity: Emotional-Coping, Problem-Solving and Entrepreneurship.